SOCIAL WORK IN HEALTH CARE

Behavioral health treatment delivery by social workers in accountable care organizations
Miller-Rosales C, Meara E, Murphey J, Dasgupta A and Lewinson T
Nearly half of Traditional Medicare beneficiaries receive their care through an Accountable Care Organization (ACO), in which provider groups are subject to healthcare cost and quality benchmarks for a defined patient population. Although the skills of the social work profession align with the goals of these contracts (coordination of service needs across multiple health and social care settings), there is little information on social worker inclusion as behavioral health providers in ACOs. We developed and administered a national survey of organizations ( = 227) with Medicare and Medicaid ACO contracts to provide an estimate of the percentage of ACOs that reported social worker-delivered behavioral health treatment. Approximately half of the respondents reported that social workers delivered mental health treatment, while a third reported that social workers delivered substance use treatment. Organizations that included specialty mental health treatment facilities were more likely to report social worker-delivered mental health and substance use treatment. Organizations that included rural healthcare facilities were less likely to report social worker-delivered substance use treatment. By describing the prevalence and predictors of social worker-delivered behavioral health treatment in ACOs, this study contributes foundational estimates for future research on the role of this important workforce in ACOs.
Perceived effects of a home-based social care program on palliative care in Spain from the caregivers' perspective
Marquina Márquez A, de la Rosa Gimeno P, Prieto Lobato JM, Rodríguez Sumaza C and Lucas García J
This study explores the perceived effects of a home-based end-of-life social care program in palliative care in Spain, from the perspective of caregivers. A qualitative study using semi-structured interviews with 75 caregivers from the INTecum project. Non-probability purposive sampling was used to recruit the study participants. The analytical process followed a thematic analysis. Caregivers expressed several factors that were influential in reducing stress and anxiety. Knowing that they can count on a case manager in a situation of need was highlighted as very positive. Another important factor that helped to create a positive sense of security was the speed of the project in offering its services. One of the problems that arose was the lack of support in situations where a transition between home and hospital care was required. Aspects such as listening and kindness, and affection, are highlighted in a very positive way. In addition to the final desires, caregivers also recognized that it was important for professionals to take their relative's wishes into account when making decisions. Incorporating a psychosocial component in palliative care for both patients and family caregivers is recognized and such actions are recommended, as well the strengthening of social and health care coordination.
Prescription for health-care social work - labor unions
Cristofalo MA and Wood L
Transformations in health care and attendant social work responses have eroded a health-care social work role grounded in holism and social justice. Tracing events at the intersection of social work, the labor movement, and health-care provision, this paper examines the evolution of social work's gravitation to micro-level practice and professionalism at the expense of macro practice, including labor organizing. It argues that engagement between health-care social work and labor unions is mutually beneficial and indispensable in preserving a role that reflects social work values in the face of massive socioeconomic inequality and health-care corporatization.
Navigating the holistic conceptualizations of mental health issue in social work: a cross-cultural study of practitioner perspectives
Cui J
Holistic approaches, such as the Biopsychosocial model, have become mainstream frameworks for organizing mental health services in recent decades. However, little research has explored how frontline social workers embrace and synthesize the different dimensions within this holistic approach. This paper uses semi-structured interviews to investigate diverse conceptualizations of mental health issues among frontline social workers. Fourteen social workers from Hong Kong and twelve from Sydney were interviewed. Three prevalent positions were identified: prioritizing chemical imbalance, questioning the concept of illness, and refusing a fixed understanding of mental health issues. The analysis also reveals how these understandings influence frontline social work practice, uncovers broader socio-cultural influences through s cross-cultural lens, and highlights implications for social work education for navigating the inclusivity of holistic approaches.
Evaluating the effectiveness of social workers as lead community care coordinators of a large integrated veteran affairs health care system in the Southeast region
Riley L
A Veteran Affairs Health Care System (VAHCS) in the Southeast region implemented the Social Workers as Lead Community Care Coordinators (SWLCCC) program to prevent delays in care coordination for veterans admitted to community hospitals. This study examines community hospital care coordinators' perceptions and satisfaction levels with the SWLCCC program. An explanatory sequential mixed method research design was used. Surveys were analyzed using descriptive analysis and chi-square test of association and interviews were analyzed using thematic analysis. Results showed that care coordination assistance has improved since the veteran-centered social work-led program was implemented.
The effect of visual education aimed at the basic needs of individuals with disabilities on the health literacy and life quality of caregivers
Açıl D, Sevgi Dogan E, Bilgin N, Eser B, Sengül N, Mutlu B, Sivecan H, Sevener U, Mizrak S, Atli Ozbas A and Erkus ME
The aim of this research is to evaluate the effect of visual education for the basic needs of people with disabilities on the health literacy and life quality of caregivers. The study sample comprised 268 caregivers evaluated in a pretest-posttest pattern. The data were collected using a Personal Information Form, the Health Literacy Scale, and the World Health Organization [WHO] Life Quality Scale-Short Form. Data were evaluated with the Wilcoxon test and Spearman correlation analysis. Following the education given to caregivers, an increase was determined in the Health Literacy Scale sub-dimension of information comprehension and in the WHO Life Quality Scale-Short Form sub-dimension of social relations. Thus it was seen that the visual education increased the health literacy and life quality of the caregivers.
Long-term impacts of socioeconomic status and childhood trauma on depression in older adults: social work strategies
Jiang F, Liu Y, Niu H, Du S, Gong L, Yang X, Rao F, Wang H and Wu H
This study explores the impact of life course socioeconomic status (SES) and childhood trauma on depressive symptoms in Chinese middle-aged and older adults, while also examining the role of chronic diseases and implications for social work practice. Using data from 9,942 participants, structural equation was established to investigate these relationships. Results reveals that low childhood SES positively affects depressive symptoms through low SES in mid-to-late life (std.  = 0.168,  < .001), and domestic child abuse negatively impacts depressive symptoms through low SES in mid-to-late life (std. =-0.020,  < .001). Additionally, experiencing peer bullying is directly associated with depressive symptoms (std.  = 0.145,  < .001). Exposure to domestic violence is directly related to depressive symptoms (std.  = 0.078,  < .001) and indirectly leads to more severe depressive symptoms through chronic disease (std.  = 0.023,  < .001). Social workers in healthcare settings can utilize these findings to better understand risk factors for depression and provide trauma-informed care and economic assistance across the life course. Additional training for social workers on the lasting impacts of childhood adversity is warranted. By intervening at both individual and policy levels, social work practitioners can help break cycles of poverty and poor health stemming from childhood.
Humanizing medicine: a patient perspective
Evanson JN
The purpose of this research was to explore patients' shared perceptions of what makes them feel valued and devalued during in-patient and out-patient medical visits and patients' recommendations for increasing feelings of value. A criterion-based snowball sampling method was used to recruit participants who are adults living in Anchorage, Alaska, and have had an in-patient or out-patient medical visit within at least the past year. Semi-structured qualitative interviews were conducted using eight open-ended questions via Zoom web conferencing. Data were stored and managed electronically. A thematic analysis approach guided data analysis. A phenomenological approach was applied to capture participants' shared experiences. This study's key findings highlight a shared patient perception that communication is paramount in conveying value: conversations with healthcare providers instill value, feeling valued is essential to well-being, feeling devalued is driven by depersonalization, and devaluation perpetuates discontinuity in healthcare.
Trends and geographic differences in social work telehealth utilization
Hua CL, Halladay CW, Rudolph JL, Celardo C, Heyworth L, Harmon AR, Mills WL and Cornell PY
We plotted trends in social work telehealth use among Veterans in a U.S. national social work staffing program and examined the relationship between geographic factors (rurality and neighborhood disadvantage) and telehealth use (audio and video) using linear probability models. Social work telehealth use increased among Veterans during the COVID-19 pandemic. There were no geographic differences in telephone telehealth use. Video telehealth use was less common among Veterans in isolated rural areas and among Veterans in highly disadvantaged areas. Outreach efforts can address barriers that Veterans who live in rural and disadvantaged areas may experience in using video telehealth.
Innovations in efficient, effective and quality oriented practices and procedures in healthcare social work
Dobrof J, Craig SL and Ferruzzi L
Older adults' perceptions of ageism, discrimination, and racism
Tice-Brown D, Kelly P, Heyman JC, Phipps C, White-Ryan L and Davis HJ
Older adults often experience different forms of discrimination, whether it be on the basis of their age, gender, race, or ethnicity (Rochon et al. 2021). Many older adults have stated they have experienced the health care system differently because of their race or ethnicity . Understanding older adults' experiences and their perceptions of ageism and racism can guide future work. This observational cross-sectional study captured community-dwelling older adults' perceptions about their experiences with ageism and racism. A few opened-ended questions were included in the cross-sectional survey. While results did not yield differences with respect to perceptions of ageism by race; there were statistically significant results in regard to perceived racism, with higher scores on the racism scales for individuals who self-identified as Black. Discussion and implications for practice, policy and research are explored.
Who is behind the robot? The role of public social workers in implementing robotic eldercare program in South Korea
Shin H and Lee OE
A companion robot named Hyodol is a digital technology implemented for eldercare in South Korea. Drawing insights from semi-structured interviews with public social workers actively involved in the Hyodol care program, this study explores how social workers contribute to the success of the robotic care program. Throughout the phases of selecting potential users, introducing older adults to the robot, and maintaining the robotic program, the practical wisdom of social workers plays an important role. Despite the increased workload in case management and the emotional labor associated with navigating the care system, these pioneering social workers maintained high morale to adopt the robotic care system. By shedding light on the specific roles of social workers, this study contributes to a deeper understanding of the intricate dynamics that underlie successful robotic eldercare.
The effect of caregivers' care burden and psychological resilience on the psychosocial adjustment of patients with open heart surgery in Turkey
Öksüz Kargın D and Dil S
This cross-sectional study investigated the effect of caregivers' care ( = 100) burden and psychological resilience on the psychosocial adjustment of patients ( = 100) with open heart surgery. Patients had poor psychosocial adjustment. Caregivers who felt incompetent in providing care had a higher care burden and a lower psychological resilience than those who did not. In addition, patients whose caregivers had higher resilience and lower burden of care had better psychosocial adjustment. The results of this study compellingly demonstrate the importance and necessity of supportive and preventive clinical social work interventions to enhance patients' adaptation to a new lifestyle and compliance with treatment during the cardiac rehabilitation process, and reduce the burden on caregivers.
Delineation of core roles of oncology social workers in inpatient settings: a secondary data analysis
BrintzenhofeSzoc K, Guan T, Middleton A, Otis-Green S, Schpamire T, Rayton M, Nelson K, Grignon ML and Zebrack B
There is limited literature on the roles and tasks conducted by oncology social workers (OSW) who work with cancer patients in inpatient units. The purpose of this study was to delineate the roles reported to be significant to practice among OSWs who practice in inpatient settings and to identify the domains into which these roles fall. The data used in this secondary data analysis were collected in a large national study of OSWs to delineate the roles and tasks across all cancer settings. The sample extracted for this study were 240 OSWs who endorsed providing direct care to cancer patients in inpatient settings. Exploratory factor analysis revealed eight factors made up of 34 tasks. The roles were aligned with three of the four service areas in the Association of Oncology Social Scope of Practice and seven of the nine competencies set forth by the Council of Social Work Education. The findings can be used to enhance communications about the roles of inpatient OSWs across OSW constituencies, increase awareness of the role supervision and consultation to ensure equitable and just practice, enhance social work coursework to prepare students to work in healthcare inpatient settings, and in future research.
Wellness in Chronic Care (WCC) families, illness & disability: an integrative clinical intervention model
Feigin R, Drory M, Dori N, Krulik T and Kedar R
This paper describes the Wellness in Chronic Care (WCC) model, an innovative integrative clinical intervention method aimed at helping social workers manage the care of patients living with chronic illnesses and their families. The goal is to propose appropriate clinical responses to the changing reality of the health system. This new reality poses new challenges that require caregivers (social work practitioners and family members) to develop suitable skills and expertise. The intervention method we developed offers a new paradigm that entails partnership and the need to assume responsibility in decision-making while coping with the illness over time. The intervention provides practical tools and methods for coping and managing the illness. These factors have contributed to building a specifically tailored intervention program for patient and family care to achieve an effective and meaningful wellbeing. An assessment of the training program of the intervention model and its implementation is presented. The model was found to be essential yet some found it difficult to make the needed changes.
Evaluation of coping strategies of parents of children with cystic fibrosis
Arslan Şahbaz EE and Cankurtaran Ö
This cross-sectional quantitative study was conducted to evaluate the coping strategies of parents of children with cystic fibrosis. The research sample is the parents (n: 112) who presented to Thoracic Medicine Department at Hacettepe University Pediatric Hospital between 3 April 2021 - 28 May 2021 and volunteered to participate in the study. Sociodemographic Data Form and Coping Orientation to Problems Experienced Inventory (COPE Inventory) were used in the collection of data. The study examined coping strategies according to children's characteristics such as age, sex, education, and parents' independent variables such as employment status, income status, number of individuals and children in the family, communication with other families, social and financial support. Data were analyzed using Mann-Whitney and Kruskal-Wallis tests. Research findings show that religious coping was the most frequently preferred coping strategy, and behavioral disengagement was the least commonly used coping strategy. Emotion-Focused Coping Strategies were also commonly used. Social work interventions and strategies play an important role in helping parents to adopt positive coping strategies and improve their skills.
Identifying depression, diabetes distress, and suicidality among adolescents with diabetes
Glick BA, Chan Hong KM and Hoffman RP
This study explored the frequency of adolescents with diabetes who endorse suicidality on the Patient Health Questionnaire (PHQ-9) with varying degrees of depression scores. Additionally, compared whether diabetes distress levels from the Problem Areas in Diabetes-Teen (PAID-T) assessment tool is associated with and without suicidal ideation. Χ analysis was used to assess differences in subjects with or without suicidal ideation based on depression severity. Since all the data were nonparametrically distributed (Shapiro-Wilk test,  < .05), Kruskal-Wallis test assessed differences in continuous variables. Overall, 27 of 355 adolescents screened endorsed suicidal ideation. Both PHQ-9 [13 (9-17.8) vs 1 (0-4.5)] and PAID-T [88 (61.8-104.5) vs 40 (30-58.8)] scores were significantly higher in patients with suicidal ideation. The frequency of suicidal ideation increased with the severity of depression. The frequency of severe depression was higher in adolescents with type 2 diabetes ( = 48) than in type 1, but there was no difference in suicidality. Adolescents with no demonstrable or minimal depression can still have potential suicidal ideation. Suicidality is a separate construct that should be screened routinely and apart from any measures screening for distress or adjustment disorders associated with adolescents experiencing life-long chronic conditions in a healthcare follow-up setting.
: medical social workers' experiences transiting older adults from hospital care to nursing home in Nigeria
Esther Oyebade O, Oyinlola O and Asenjo Palma C
Very few literatures have focused on transition of older adults from hospitals to nursing homes in African region. As a first step, this study explored the experience of medical social worker when transiting older adult from the hospital to nursing home in southwestern region of Nigeria. A descriptive qualitative approach collected through a semi-structured interview among 16 medical social workers showed that there is limited availability of nursing home facilities in Nigeria. Additionally, bureaucratic and administrative hurdles often added to the complexities of facilitating seamless transitions into nursing care homes. Cultural beliefs and family dynamics exert a substantial influence on the decision-making process, making the task of medical social workers even more intricate. There is a need for a greater support from policymakers and healthcare authorities to address the challenges facing Nigerian medical social workers. Hence, to better understand and address these experiences, the healthcare system can better equip medical social workers to navigate the transitions effectively and ensure the well-being of older adults during this crucial phase of their lives is adequately supported.
Addressing loneliness in older adults: predictors, protective factors, and implications for social work practice
Satorres E, Delhom I, Llopis J, Navarro-Prados AB, Bueno C and Meléndez JC
Loneliness significantly impacts the mental well-being of older adults, prompting an examination of psychological predictors and buffering factors associated with it in this demographic. A cross-sectional study involving 246 community-dwelling older adults was conducted. The UCLA Loneliness Scale identified predictors of loneliness, including negative mood, hopelessness (negative future expectations and loss of motivation), and despair. Buffering factors included ego-integrity, personal growth, and purpose in life. Regression analysis revealed that negative mood, negative future expectations, and despair increased loneliness, with negative mood showing a strong association. Conversely, ego-integrity, personal growth, and purpose in life reduced loneliness. The study underscores the complex interplay of psychological factors shaping loneliness in older adults, highlighting the importance of addressing both risk and protective factors. Social work practitioners in healthcare settings can play a pivotal role in addressing loneliness among older adults by leveraging these factors.
Addressing substance use disorder in a hospital prenatal setting
Burgos L and Gelband M
Pregnancy can be a time of joy and hope but, for birthing parents struggling with a substance use disorder (SUD), it can be challenging. Social stigma, shame, and the potential legal ramifications present barriers to individuals seeking the care they need. Marginalized groups, in particular, face challenges that put them at even greater risk for substance misuse. Substance use during pregnancy can further impair the individual's level of functioning, and it has also been associated with problems in the social, emotional, and cognitive development of their children. Pregnancy and addiction each require guidance and good medical care. By integrating substance misuse treatment services under the umbrella of their medical care, clinics facilitate timely access to care, as well as help break the stigma associated with substance misuse. Our program offers a comprehensive and multidisciplinary approach to support pregnant individuals with SUDs. Interventions include support, education, case management, and mental health counseling. By providing optimal prenatal care early on, individuals can receive the treatment that they need so that they can achieve physical and emotional stability once the baby arrives, which ultimately has better outcomes for the parent and child's health and wellbeing.
Mothers' choice of health management services for under-five children with common illnesses: evaluating social workers' impact in Nigerian health sector
Ene J, Ebimgbo S, Onalu C, Okah P, Ekoh PC and Agha AA
Every child deserves the right to life. In Nigeria like other African countries, a high burden of child mortality prevails. Attaining a low-mortality rate of children entails that mothers who are the primary caregivers are in the best position to provide quality healthcare management.